Healthcare Provider Details

I. General information

NPI: 1598093999
Provider Name (Legal Business Name): SOLLEYS HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4239 W 95TH ST
OAK LAWN IL
60453-2623
US

IV. Provider business mailing address

4239 W 95TH ST
OAK LAWN IL
60453-2623
US

V. Phone/Fax

Practice location:
  • Phone: 708-529-0188
  • Fax:
Mailing address:
  • Phone: 708-529-0188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. PAT BRETT
Title or Position: DIRECTOR
Credential: CADC
Phone: 773-396-4026